CGRN Hepatobiliary and Pancreatic Disorders

Question 1

A patient with cirrhosis develops confusion, asterixis, and an elevated ammonia level. Which intervention is the priority?

Accepted Answer

Administer lactulose as ordered

Answer

Lactulose reduces ammonia absorption in the colon by acidifying the gut lumen, making it the first-line treatment for hepatic encephalopathy.

Question 2

Which finding on a liver biopsy is most characteristic of primary biliary cholangitis (PBC)?

Accepted Answer

Granulomatous destruction of bile ducts

Answer

PBC is characterized by autoimmune granulomatous destruction of interlobular and septal bile ducts, which is pathognomonic for this condition.

Question 3

A patient presenting with severe epigastric pain radiating to the back, elevated lipase, and grey-Turner sign most likely has which condition?

Accepted Answer

Acute hemorrhagic pancreatitis

Answer

Grey-Turner sign (flank ecchymosis) indicates retroperitoneal hemorrhage, which combined with elevated lipase and epigastric pain is consistent with acute hemorrhagic pancreatitis.

Question 4

Which lab abnormality pattern is most consistent with obstructive jaundice from a common bile duct stone?

Accepted Answer

Elevated direct bilirubin, markedly elevated ALP and GGT

Answer

Obstruction of bile flow leads to conjugated (direct) hyperbilirubinemia along with marked elevation of cholestatic markers ALP and GGT.

Question 5

During ERCP for suspected choledocholithiasis, the nurse notices the patient's oxygen saturation drops to 88%. What is the first action?

Accepted Answer

Notify the physician and apply supplemental oxygen

Answer

Desaturation during ERCP is a sedation-related adverse event; the nurse must immediately notify the physician and apply supplemental oxygen to prevent hypoxic injury.

CGRN - Certified Gastroenterology Registered Nurse Practice Test

CGRN - Certified Gastroenterology Registered Nurse Practice Test

CGRN Hepatobiliary and Pancreatic Disorders